What Pattern of Diet to be Followed In Hepatic Diseases?

Hepatic Disease is nothing but the diseases of liver, there are so many different types of hepatic diseases they are jaundice, cirrhosis, acute liver failure, hepatitis, hemochromatosis, hepatic encephalopathy, portal hypertension. The symptoms of liver disease are vomiting, abdominal pain, increased level of bilirubin in blood, lethargy, fatigue, nausea, weight loss.. So now we came to know what are the liver diseases and its symptoms. Let’s discuss about diet pattern of hepatic disease patients.

-In Cirrhotic patients the main standard values of calorific calculation is

55%-Carbohydrate

30%-Fat

15%-Protein

To prevent the negative nitrogen balance in patients with hepatic insufficiency, a protein intake of 1to 1.5/kg/day is advised.

Dietary fat to be restricted in patients with steatorrhea otherwise should be unmodified.

In a malnourished patient decrease in dietary fat should be balanced by an increase in calories from other food sources, preferably carbohydrates.

In patients with portal hypertension and ascites, restriction of fluid and sodium intake is done.

An unpalatable diet may lead to an malnutrition which is common in advanced liver disease.

Ascites is associated with anorexia and has been shown to increase energy expenditure

Nausea most commonly found in liver disease, further it decrease the dietary

Protein restriction is no longer recommended for patients with mild to moderate hepatic encephalopathy.

Reduction in the frequency of infectious complications, decreased in hospitalization and improvement in hepatic function is also seen in patients with liver disease in response to nutritional support.

Malabsorption and poor dietary intake associated with alcoholic are other common reasons for malnutrition in chronic liver disease.

Nutrients, Nutraceuticals and Functional foods in hepatic diseases

Silymarin- Silymarin is derived from seeds of silybum marianum (milk thistle). It is used in traditional medical systems for treatment of portal hypertension and other liver diseases, it reduces the insulin resistance and Silymarin supplementation helps in lowering insulin requirements in patients with cirrhosis-related diabetes mellitus. Silymarin decreases the liver related mortality.

Picroliv- Extracts of rhizome picrorhiza kurooa has used in traditional indian medicine for treatment of liver diseases. It helps in free radical quenching, in animals Picroliv stimulated liver regeneration, enhance detoxification from malaria-induced damage and has anti-inflammatory and anti-cholestatic properties.

Veg- protein– A diet deriving protein from plant sources decrease the incidence of hepatic encephalopathy in patients with cirrhosis.

Branched chain keto acids- Use of branched chain keto acids in patients intolerrent of standard protein may be appropriate.

Amino acids- Cysteine and tyrosine are non essential amino acids whose synthesis by hepatocytes is impaired, in chronic liver disease inclusion of these amino acids in the diet may be essential when liver disease is advanced.

Trace elements-Zinc supplementation has shown to improve both glucose tolerance level in patients with cirrhosis and hepatic encephalopathy in alcoholic patients.

Vitamins-Use of multivitamin supplement is advocated for all patients with chronic liver disease. Thiamine supplementation is indicated in all alcoholic patients. Patients with ascites should consume a salt restricted diet and if necessary at certain times water restricted diet is advised.

S-Adenosyl-L-methionine- It is a precursor in formation of essential amino acid methionine is known to be deficient in many forms of liver disease. Supplementation of this compound improve the biochemical parameters of liver disease .